A long-term cure for HIV in the offing?

7/26/2013 – Nowadays an HIV/AIDS infection is treated with anti-retroviral medication (costing over $15,000 per year). Problem is that the disease is reignited as soon as the therapy is suspended. Now an Italian lab has achieved long-term remission in macaques, after a single three-month course. Why are we telling you this on a chess newspage? Because the grad student involved is chess IM Luca Shytaj.

A short biographical sketch of IM Luca Shytaj

His name is Iart Luca Shytaj, and he was born in Albania (Tirana) in 1986.
His parents moved to Italy when he was six years old and he became an Italian
citizen, with dual Italian-Albanian citizenship, in 2007. Luca (as he is
known to friends) is an International Chess Master and has one GM norm,
earned in the Tromso Open 2009. He represented Albania twice in Olympiads
(Calvia 2004 and Turin 2006) and Italy once in an Olympiad (Dresden 2008
– the picture above, by Cathy Rogers, was taken there) and once in
a European Team Championship (Novi Sad 2009). He won the Albanian Championship
(2003) and the Italian Rapid Championship (2009). His highest rating ever
was 2507 (current rating 2456).

In the scientific field Luca holds a master degree in Genetics and Molecular
Biology (from the “La Sapienza” University in Rome; his bachelor degree,
from the same University, is in general Biology). Currently he is doing
a PhD in Medicine (the full name of the course is “Medical Microbiology,
Immunology and Infectious Diseases”). He performs his research both at the
Italian Institute of Health in Rome and in the United States (Maryland)
at Bioqual Inc. (a company collaborating with the Institute of Health).

Luca Shytaj is the first author of both the articles in which the authors
show the results of their novel therapy. He has also presented this work
in several scientific conferences (Fifth International Workshop on HIV
Persistence During Therapy, Sint Maarten, West Indies 2011; Towards
and HIV Cure, International AIDS Society’s Pre-Conference Symposium
Washington DC, USA; HIV DART, San Diego, California, USA 2012). Luca
kindly sent us the following summary of his scientific work.

Background of the research

AIDS, caused by human immunodeficiency virus (HIV), is a major disease
of mankind, having already caused more than 30 million deathssince its outbreak in the early 80’s and currently affecting
≈34 million people worldwide.

At the present time, the most successful treatment available for HIV
infection is antiretroviral therapy (ART; usually in the form
of a combination of at least three drugs). Antiretroviral therapy can
stop viral replication and thus prevent the progression of HIV infection
to AIDS.

Antiretroviral therapy, however, cannot completely eliminate the
virus from the infected individual.As soon as the therapy
is suspended the virus quickly takes over again, recreating the pre-therapy
scenario.

Thus, antiretroviral therapy bindsthe patient to lifelong
therapy adherence. This results in several problems such as drugtoxicities, drug resistance (that may render the treatment
ineffective) and a decreased life expectancy.

Even the sub-optimal scenario of antiretroviral treatment is not
accessible to the majority of HIV infected people since they live
in low/very low income countries (most of the HIV infect population
lives in sub-saharian Africa) and cannot afford the very high cost of
antiretroviral drugs (usually >15,000 US$ per year per patient).
Also in high income countries (for example US), the poorest sections
of the population are often unable to meet the expenses required for
treatment. In the countries in which these expenses are covered by the
government, they represent a significant burden for the health sector.

Moreover, the absence of a cure for HIV results in the persistence
of a widespread stigma towards the infected population.

Our research goals and results

Our research project is aimed at finding a cure for HIV/AIDS
that should allow the patients to either get rid of the virus completely
(this is called “sterilizing cure” in the medical community),
or to autonomously control the virus without showing disease symptoms
and without the need for lifelong drug assumption (this is called “functional
cure”).

The research is funded by the Italian Institute of Health (based in
Rome) and is carried on with the collaboration of several universities
and private companies both in Italy and in the US. The “core” research
group is the one at the Italian Institute of Health, and the project
director is Dr. Andrea Savarino (MD), my PhD thesis advisor.

Our work is conducted on monkeys (more precisely, on macaques).
The macaques are infected with a virus that is closely related to HIV
(it’s called SIV, “S” stands for simian). This virus causes AIDS like
the human virus, but it is more aggressive and thus macaques usually
develop the symptoms of AIDS earlier than humans.

Our most important result so far has been the achievement of a functional
cure(see point 1) in macaques. We achieved this result
by using a combination of antiretroviral therapy (the standard baseline
therapy for HIV infected patients) and two experimental drugs: auranofin
and buthionine sulfoximine.

Our drug combination is administered only once and only for three
months. After these three months the therapy is stopped and the
macaques are able to control the virus independently without showing
signs of disease progression.

The rationale of our therapy is to induce a safe and gradual replacement
of the "diseased" white blood cells (that are the cells
infected with the virus) with fresh and efficient cells. Moreover,
our therapy is able to boost a specific branch of the immune system
and, as a consequence, the immune system can control the virus after
the therapy is stopped. The virus is still present in the organism,
but it is kept constantly under check and thus is unable to cause AIDS.

The main advantage of our therapy over the current situation is that
it spans for three months instead of the whole life of the patient.
This may allow to provide a globally scalable curing strategy.

The main advantages of our therapy over other proposed curing solutions
are that:

We tested our therapy in the “late” phase of the disease
(in medical terms, the “chronic phase”). The great majority of the
infected population is revealed to be HIV positive in the chronic
phase. Other strategies have obtained good results in the “early”
phase (“acute” phase) in which the virus is less widespread and thus
easier to target. Unfortunately only a very small minority of the
patients is detected to be HIV positive during the early phase and
thus successful treatments during this phase have no real impact on
a global or even national scale.

Our therapy proved to be safe on macaques and relatively easy to
administer. Moreover, the individual components of our drug combination
have good safety profiles on humans. The only other therapies that
have been successful in the chronic phase of the disease (one of them,
performed in Berlin, achieved the complete elimination of the virus
in the patient) require life threatening procedures such as aggressive
chemotherapy followed by stem-cell transplants and thus their use
has been restricted only to patients that have not only HIV but also
advanced cancer.

The results have been cited by non-specialized media both in Italy
(for example in the main national newscast TG1 or in major newspapers
such as “La Stampa”) and abroad (for example in the San Francisco Chronicle).

See also

8/25/2013 – Magnus Carlsen seems to have found everything at the Championship venue in order. We have a new video with HD footage of the 2000 screaming girls (and Carlsen's reaction to them), as well as the toughest simul of his life! There is also an interview with Anand, who, asked whether the home turf provides special motivation, replies: "I would be motivated to win if the match was played on the moon."Discuss

8/19/2013 – That's WW2 military slang for reconnaissance. World Championship challenger Magnus Carlsen from Norway landed in Chennai on Sunday to get a feel for the venue of the November championship. It's a maiden visit to the city, and he's loving every bit of it, revealed his manager Espen Agdestein. Out of caution Magnus has brought his own chef. First reports in the Indian broadsheets.Discuss

Discuss

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